Effect of mini-open rotator cuff repair combined with intraoperative cocktail therapy in the treatment of rotator cuff injury: a prospective comparative study between the cocktail therapy and the control group

Introduction

To investigate the clinical effect of mini-open rotator cuff repair combined with intraoperative cocktail therapy in the treatment of rotator cuff injury.

Methods

A prospective comparative study of 78 patients with rotator cuff injury who underwent mini-open rotator cuff repair in our hospital from January 2020 to January 2022 and used block randomization to divide patients into 2 groups in this trial: The cocktail group received 150 mg ropivacaine, 40 mg of methylprednisolone succinate, 0.3 mg of epinephrine, and saline solution to a total of 100 mL, whereas the control group received 100mL of saline solution. The drug mixtures were injected into the glenohumeral joint, subacromial bursa, and anterior, middle, and posterior parts of the deltoid muscle. The patients’ visual analog scale (VAS) scores preoperatively were recorded at 6, 12, 24, and 48 h postoperatively. We also recorded the Constant-Murley function scores and passive abduction angles of the operation shoulder at two weeks, one, three and six months postoperatively. We also compared the number of patients using postoperative celecoxib capsules and receiving parecoxib sodium injections; the number of patients experiencing nausea; the patients with infection; the course of disease and the tear size.

Results

The cocktail group constituted 39 shoulders (50.0%), with 16 men (41.0%) and 23 women (59.0%); the mean age was 58.71 ± 6.39 years; the mean BMI was 24.25 ± 4.50 kg/m ². The control group constituted 39 shoulders (50.0%), with 18 men (46.2%) and 21 women (53.8%); the mean age was 59.71 ± 10.78 years; the mean BMI was 23.25 ± 3.73 kg/m ². We found no significant difference in sex, age and BMI between the 2 groups (P = 0.647, P = 0.620, P = 0.289). The VAS scores at 6, 12, 24 and 48 h postoperatively were significantly lower in the cocktail group (P = 0.023, P = 0.036, P = 0.014, P = 0.017). The number of patients receiving celecoxib capsules and parecoxib sodium injections tended to be lower in the cocktail group, and the difference was significant (P = 0.001, P = 0.001). There was no significant difference in the incidence of nausea(P = 0.617), infection, the course of disease(P = 0.182) and the tear size (P = 0.649)between the two groups. The Constant-Murley functional score and passive abduction angle of the operation shoulder were significantly improved in all patients after surgery, and there was no statistical difference in the functional score and active abduction angle of the operation shoulder between the two groups preoperatively (P = 0.430, P = 0.183) and at three(P = 0.468, P = 0.832) and six months postoperatively(P = 0.110, P = 0.381). However, at two weeks (P = 0.001, P = 0.001) and one month postoperatively (P = 0.001, P = 0.001), the Constant-Murley functional score and the passive abduction angle of the operation shoulder in the cocktail group were significantly higher than those in the control group.

Conclusions

The mini-open rotator cuff repair has satisfactory curative effect in the treatment of rotator cuff injury, and intraoperative cocktail therapy can alleviate postoperative pain and speed up postoperative functional rehabilitation and improvement of joint range of motion.

Level of evidence

Level III, therapeutic study.